no title

Medical research

Research seeks at-home stroke therapy

Enlarge ImageRequest to buy this photoAdam Cairns | DispatchChuck Popovich, 54, is reflected in the computer tower as he waves his arm in a paddling motion to maneuver a canoe through the video game course during a rehabilitation session at Ohio State University.

More Articles

Chuck Popovich sat in an office chair last month, moving his left arm in a circle above his
head.

Beads of sweat collected on his forehead as he concentrated on the screen in front of him where
a robotic-looking boater floated on a river filled with obstacles, including overhead metal pipes
and swooping bats.

When Popovich’s arm circled down by his side, the boater’s hand followed, paddling down into the
river and propelling his vessel forward, toward an eye-level pipe. Popovich ducked, and the boater
followed his lead, avoiding a virtual concussion.

All of this was going on in a research room at Ohio State University in hopes that it will help
stroke survivors recover from lingering troubles.

The 54-year-old Blacklick man had a stroke in 2007 and is part of a study using technology —
including a Microsoft camera that reads body movement — to bring a superior, but rarely used form
of rehabilitation into the homes of stroke patients and others with neurological damage that
impedes movement on one side.

A team of researchers from a variety of disciplines, including physical therapy, neuroscience,
engineering, psychology and computer science, is developing a computer-game-based system with help
and feedback from people who have had a stroke.

A mountain of literature supports the benefits of constraint-induced movement therapy, or CI
therapy, said Lynne Gauthier, the lead researcher and assistant professor of physical medicine and
rehabilitation. It focuses on certain movements that easily translate into the actions of everyday
life, which isn’t often the case with traditional therapy, she said.

But the majority of stroke patients have no access to the therapy, largely because most insurers
don’t pay for it. Those who go to a center that offers it and pay out-of-pocket are looking at
bills of as much as $9,000, Gauthier said.

This summer, the researchers plan to start the second phase of the study, testing the system in
the homes of people who have had strokes. They’ll be expected to use the system three hours a day
for two weeks.

“It’s like boot camp for the affected side,” Gauthier said.

It’s too soon to say if this will prove effective enough to warrant development of a marketable
product.

Extending the affected arm and fingers and turning the arm outward or above the head can be
particular challenges for those who’ve had a stroke, which is why the game currently focuses on the
arm-paddling motion, said Linda Lowes, a physical therapist from Nationwide Children’s
Hospital.

The system also includes a list of questions designed to check on a patient’s progress, such as
using the affected hand to drink and brush teeth.

When the in-home study starts, participants will meet with a therapist weekly to discuss
progress and challenges. And the game will become more difficult as the participants improve.

It’s unclear how much the at-home software will cost, but users would need a computer, monitor
and a $200 motion-detection camera, researchers said.

Roger Crawfis, an OSU professor of computer science and engineering, said he and his students
are working to improve the game, including adding more challenges.

Edward Taub, the director of CI therapy at the University of Alabama-Birmingham, said his team
also is working on an at-home therapy system and such advances could mean that many more stroke
patients get optimal therapy.

It could make a difference even for people who had strokes decades ago, he said.

Popovich, who also participated in a study of this type of therapy with an in-person therapist,
said it is much better than traditional therapy and has helped him gain more control of his left
side.